Thursday, March 30, 2006

More info on febrile seizures!

Routine emergency neuroimaging may be unnecessary for most children after first complex febrile seizures, according to a study performed by researchers at Columbia University's Mailman School of Public Health and the Morgan Stanley Children's Hospital of NewYork-Presbyterian. Children with a first complex febrile seizure who otherwise appear well and who have normal neurological examinations are at low risk of structural abnormalities that require emergency interventions.

The practice guidelines of the American Academy of Pediatrics recommend against the use of emergency neuroimaging for pediatric patients with simple febrile seizures, but no guidelines exist for complex febrile seizures. The new study, published in the February issue of the journal Pediatrics, provides data to potentially extend these practice guideline recommendations to children who experience complex febrile seizures.

The study's senior author is Dr. Dale Hesdorffer, assistant professor of epidemiology at the Mailman School of Public Health and the Gertrude H. Sergievsky Center at Columbia University Medical Center. The other principal authors are Dr. Peter Dayan, acting associate director of Pediatric Emergency Medicine at Morgan Stanley Children's Hospital and assistant clinical professor of Pediatrics at Columbia University College of Physicians and Surgeons and Dr. David Teng, assistant attending physician at Morgan Stanley Children's Hospital and assistant clinical professor of Pediatrics at Columbia University College of Physicians and Surgeons.

"Each year in the United States, between 130,000 and 340,000 children under five years of age will experience a first complex febrile seizure," said Dr. Hesdorffer.

"Our study suggests that for children who have first complex febrile seizures whose history and physical exam are otherwise unremarkable, routine neuroimaging may not be necessary," said Dr. Dayan. "These patients have a low risk of structural abnormalities requiring emergency surgery or medical intervention."

Febrile seizures are common convulsions that occur with fever in infants and toddlers. They are generally not harmful to the child, but are frightening for the parents. Children with febrile seizures typically have rectal temperatures greater than 101 degrees Fahrenheit. Most febrile seizures occur during the first day or two of a child's fever.

Simple febrile seizures are single, brief and uncomplicated seizures. Complex febrile seizures may last longer than 15 minutes, occur more than once during the same illness, or include a brief period of transient abnormal neurological signs on physical examination.

The study evaluated 71 children who came to the emergency room of Morgan Stanley Children's Hospital with a first complex febrile seizure. The patients were identified by emergency department physicians and trained research assistants.

The research assistants obtained detailed information from the parents on the nature of the seizure and the information was reviewed by two epileptologists to classify the seizure as simple or complex. Neuroimaging studies were performed at the discretion of the emergency physician or as part of a study of MRI in febrile seizures led by Dr. Hesdorffer.

Follow-up assessments were performed in order to determine the presence or absence of conditions that required emergent intervention, including but not limited to mass lesion, hemorrhage, hydrocephalus, abscess or cerebral edema. None of the patients demonstrated a condition requiring emergency intervention.

"Although this is the largest study of its kind, more study needs to be done to determine which children presenting with first complex febrile seizures are at risk of pathologic conditions requiring neuroimaging and emergency intervention measures," said Dr. Teng.

The study was supported in part by a grant from the National Institute of Child Health and Human Development.

Columbia University's Mailman School of Public Health

The only accredited school of public health in New York City, and among the first in the nation Columbia University's Mailman School of Public Health provides instruction and research opportunities to more than 950 graduate students in pursuit of masters and doctoral degrees. Its students and more than 270 multi-disciplinary faculty engage in research and service in the city, nation, and around the world, concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health, and sociomedical sciences.

Morgan Stanley Children's Hospital of NewYork-Presbyterian

Ranked by U.S. News & World Reports as one of the top five children's hospitals in the country, Morgan Stanley Children's Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics -- including the most complex neonatal and critical care, and all areas of pediatric subspecialties -- in a family-friendly and technologically advanced setting.

Building a reputation for more than a century as one of the nation's premier children's hospitals, Morgan Stanley Children's Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City's only hospital dedicated solely to the care of children and the largest provider of children's health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children's Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide.

Sunday, March 26, 2006

Can Atkins diet make a real difference in seizures?

Epilepsy Epilepsy is a type of neurological condition characterized by periods of abnormal electrical activity in the brain (called seizures). According to the Epilepsy Foundation, the condition affects about 2.7 million Americans. About 200,000 new cases are diagnosed every year.

Epilepsy is slightly more common in males and in African-Americans. It can develop at any age, but incidence is highest in children under two and adults over 65.

Epilepsy is classified into two main types: generalized seizures and partial seizures. Generalized seizures affect both sides of the brain from the onset and produce some loss of consciousness. They can be further divided into four subtypes. Generalized tonic clonic seizures initially cause stiffening of the limbs and temporary reduction or cessation in breathing. The symptoms are followed by limb and facial jerking and resumption of breathing.

These seizures are the most common type of generalized seizures. They are also known as Grand Mal seizures. Atonic seizures (sometimes called drop attacks) cause a sudden loss of muscle tone, leading to drooping of the head, loss of posture or sudden falling. Myoclonic seizures are rapid contractions of the muscles, usually on both sides of the body, causing sudden jerking in an area of the body. Absence seizures cause sudden lapses of awareness (like staring into space). These seizures, also known as petit mal seizures, last only a few seconds.

Partial seizures are those in which the abnormal electrical activity occurs on one side of the brain. They can be further classified as simple partial seizures (no loss of consciousness) and complex partial seizures (causing impaired or lost consciousness). In some people with partial seizures, the abnormal electrical activity can spread to the other side of the brain, causing a generalized seizure.

Treating Epilepsy Once the diagnosis of epilepsy is confirmed, medications can be prescribed to control the seizures. In 80 percent of patients, medications can effectively control some of the seizure activity. The remaining 20 percent are unable to get relief with medications.

When seizures don't respond to drug treatment, doctors may recommend surgery. Surgeons map the electrical activity in the brain and then surgically destroy the areas where seizure activity originates. Surgery is usually only recommended when patients can't get relief from medications and seizure activity is confined to a very specific, identifiable area of the brain.

The Ketogenic Diet for Seizures Some physicians advocate a special diet for certain patients with epilepsy, called the ketogenic diet. The high-fat, low-carbohydrate diet forces the body to use fat for energy (normally we get our calories from glucose in carbohydrates). When fat is used as the major source of fuel, the body produces a byproduct, called ketones.

The diet is started with the patient in the hospital under a 24-hour fast. Without food, the body begins to burn its fat stores. Doctors gradually add high-fat foods into the diet to keep the body burning fats for energy.
According to the Epilepsy Foundation, the ketogenic diet helps reduce seizure activity in 66 percent of children and completely eliminates seizures in one-third. The diet must be carefully planned and followed. Patients can develop dehydration, constipation, kidney stones or gallstones. Children on the diet must also be monitored for nutrition deficiencies.

The Atkins™ Diet for Seizures The Atkins™ diet has been a popular diet for adults trying to lose weight. In some ways, it is similar to the ketogenic diet, but not nearly as restrictive. Now, doctors at Johns Hopkins Children's Center say a modified form of the Atkins diet may be beneficial for children who can't tolerate or have difficulty following the standard ketogenic diet.

The modified Atkins diet encourages more fat than the standard Atkins diet and allows for a little more protein than the ketogenic diet. It doesn't require strict measuring of food intake, calories or fluids. Children don't need to start with a 24-hour fast or admission to the hospital.

In a small recent study, researchers reported the modified Atkins diet was almost as effective in controlling seizures as the traditional ketogenic diet. Sixteen children, aged 3 to 18, completed the study; 13 experienced at least a 50 percent reduction in seizures while on the diet. Seven of the participants had greater than a 90 percent improvement in symptoms. Four of the children were seizure-free.

Doctors caution that any high-fat diet should only be used under the guidance of a physician and nutritionist who are familiar with the benefits and risks of the therapy.

Is it possible to stop seizures?

Seizures can be as mild as a blank stare or twitching fingers, or as severe as violent muscle contractions which cause unconsciousness. Today, Jenny Bambrick will be among the first to use an entirely new tool to treat them. Don't let her youthful looks, or the trusty stuffed dog at her side fool you, Jenny Bambrick has been through more in her short 21 years than some will experience in a lifetime.

She says, "I know I could have died during that, that's what really bothers me." She could have died during any one of countless seizures. She says, "Sometimes, I remember parts of them, but not the whole thing." She has suffered seizures, mild and severe, since she was a toddler. Jenny explains what an episode is like. She says, "I just kind of blank out and when I wake up I'm kind of twitching and then they'd say that I started shaking, I was foaming at the mouth."

As a result she's been in doctor's offices and hospitals more than most. She's also had to take more medication than most. Jenny says, "They've caused me to lose a lot of work time because they make me sick." She's also had to rely on the understanding of employers, friends, and especially her fiancee', Josh, who witnessed one of her seizures without warning. She explains, "He was driving in the van and he was very scared. I felt bad."

But the two are hoping to build a life together and Jenny is willing to do almost anything to make it as seizure-free as possible. So she's willing to be a medical guinea-pig of sorts by undergoing a surgery with radiation that has been done only a handful of times anywhere in the world. Jenny says, "The only thing I'm nervous about is the halo, and that's about it." Jenny is hoping today's operation will bring her closer to a normal life. It's a life she's looking forward to with her fiancee', Josh.

But standing in the way are the seizures Jenny's suffered since she was a baby. She says, "I'd just like to get off the medication and maybe get a driver's license, cause I can't get one now." That's because she hasn't been able to predict when a seizure might strike. Dr. Wilson Asfora, with Sioux Falls Neurosurgical Associates says, "The brain is like a computer and the cells transmit electrical impulses from one to the other." Jenny's doctor has been able to pinpoint exactly where there is a short-circuit, if you will, in her brain.

That he says is the source of her seizures. Asfora says, "If we can define exactly where the seizures are coming from, the treatment of choice is removal of this area." Unbelievably, they're going to remove the area without surgery. A device, called a halo, is fitted, so that a team of specialists can precisely pinpoint the part of Jenny's brain they want to treat with high-dose radiation. Dr. Steven McGraw, a radiation oncologist with Sioux Valley's Cancer Center explains, "If there's a few millimeters of clearance, we can usually be very accurate and hit the so-called bad area and leave the normal brain alone."

Asfora adds, "The advantage of radiosurgery is that we can be more precise. It's less traumatic to the patient. There are less risks to the patient and less complications to the patient." But there is one complication, possible damage to the optic nerves, that Jenny is willing to risk, in an effort to silence her seizures. McGraw explains, "Usually this blind spot is something that patients can learn to live with, but about 40-45 percent of the patients might develop a blind spot." In Jenny's case, the procedure will require nine distinct beams of radiation delivered at nine different locations in the brain.

McGraw says, "Basically it's mostly an art form to design a number of radiation beams to spread out the radiation dose." Jenny won't know for two to three months whether today's surgery has successfully silenced her seizures. We'll of course, keep you posted on her progress.

Success of bionics against seizures a solution?

At least one of every 100 Americans has epilepsy, a disturbance in the brain's electrical activity causing recurrent seizures. These may be as mild as twitching fingers or as severe as violent muscle contractions causing unconsciousness. But we've come a long way since the disorder was considered demonic possession, and doctors now have a slew of medicines that often keep the disorder in check.

Unfortunately, not every epileptic reacts well to medicine. In 25% to 40% of patients, medications don't effectively treat the disorder, because they either don't reduce seizures or cause intolerable side effects. Many are thought to pose a risk of birth defects.

That's where implantable vagus nerve stimulators (VNS) come in. Not to be confused with the “Vegas nerve,” which promotes a desire to play slot machines and roulette, the vagus nerve starts in the brainstem and extends down past the head to the abdomen.

You may think the bionic VNS devices are inserted into the brain, the thought of which gives many of us the heebie-jeebies. But actually it's implanted just under the skin in the patient's chest during an outpatient procedure. “They're not noticeable in adults or even small children,” says Dr. Jim Wheless, Director of Le Bonheur Comprehensive Epilepsy Program at the University of Tennessee.

Small wires from the device, currently made only Cyberonics of Houston, Texas, are tunneled under the skin to the left vagus nerve in the neck. Through them are sent timed and measured electrical signals that, in pacemaker fashion, activate various areas of the brain.

But unlike with a pacemaker, recipients of VNS devices can temporarily adjust the strength of that pulse merely by running a magnet over the device. “If you're on medicine and feel a seizure coming on, there's nothing you can do to abort it,” Wheless told me. “But patients can use that magnet to - in many cases - abort, shorten, or improve recovery from the seizure.”

Ah, but too late if it's a massive convulsion (called a “grand mal seizure”), right? Wrong. “A family member can also use the magnet,” Wheless points out.

Wheless, a neurologist of 18 years who has used the VNS devices since they became available in the U.S. in 1997, nevertheless always begins with pharmaceutical therapy. “Usually we consider that if patient hasn't responded adequately to two to three drugs, VNS therapy may be appropriate,” he says.

That's sensible, because VNS epilepsy therapy costs $20,000 to $25,000, device and surgery included. Medicare and most insurance companies do cover it, though. And Wheless says while data from the US are varied because we don't have a uniform health care system, “in Europe, the device has been cost-effective” because it reduces expense from hospitalizations and injuries in general.

Worldwide almost 40,000 VNS devices are in use. One major study showed that after three years, almost three-fourths of VNS implant recipients continued to receive the therapy. Further, for those whom it does help, the benefits tend to improve over time. “We often see gradual improvement, not just in the first weeks or months, but sometimes out to even 18 months,” says Wheless.

VNS devices can also be used in conjunction with epilepsy drugs, reducing the needed amount and thereby reducing the possibility of side effects.

For epileptics with the mildest of convulsion, VNS devices aren't recommended - but neither are they only for those who suffer grand mal seizures. Actually, “most of the devices are for complex partial seizures such as stopping activity, unresponsiveness and confusion,” says Wheless. “These are no less devastating than grand mal seizures.”

VNS therapy isn't without side effects, but they tend to be mild, including local irritation, hoarseness and coughing, and these generally disappear with time.”

Says Wheless, “If you adjust the device properly, you can get close to virtually no side effects.” Further, “You can make settings in the office. I can determine results with patients standing in front of me. You can't do that with medicine.”

The FDA recently approved VNS therapy for severe clinical depression, and progress with other bionic implants shows we're truly in an exciting new age of therapies for mental disorders for which the “treatment” not so long ago was being chained to a sanitarium wall.

Thursday, March 23, 2006

Bionic device can control seizures?!

At least 1 of every 100 Americans has epilepsy, a disturbance in the brain’s electrical activity causing recurrent seizures. These may be as mild as twitching fingers or as severe as violent muscle contractions causing unconsciousness. But we’ve come a long way since the disorder was considered demonic possession, and doctors have a slew of medicines that often keep the disorder in check.

Unfortunately, not every epileptic reacts well to medicine. In
25% to 40% of patients medications don’t effectively treat the disorder, either because they don’t reduce seizures or cause intolerable side effects. Many are thought to pose a risk of birth defects.

That’s where implantable
vagus nerve stimulators (VNS) come in. Not to be confused with the “Vegas nerve,” which promotes a desire to play slot machines and roulette, the vagus nerve starts in the brainstem and extends down past the head to the abdomen.

You may think the bionic VNS devices are inserted into the brain, the thought of which gives many of us the heebie-jeebies. But actually it’s implanted just under the skin in the patient’s chest during an outpatient procedure. “They’re not noticeable in adults or even small children,” says Dr. Jim Wheless, Director of Le Bonheur Comprehensive Epilepsy Program at the University of Tennessee.

Small wires from the device, currently made only
Cyberonics of Houston, Texas, are tunneled under the skin to the left vagus nerve in the neck. Through them are sent timed and measured electrical signals that, in pacemaker fashion, activate various areas of the brain.

But unlike with a pacemaker, recipients of VNS devices can temporarily adjust the strength of that pulse merely by running a magnet over the device. “If you’re on medicine and feel a seizure coming on, there’s nothing you can do to abort it,” Wheless told me. “But patients can use that magnet to – in many cases – abort, shorten, or improve recovery from the seizure.”


Ah, but too late if it’s a massive convulsion (called a “
grand mal seizure”), right? Wrong. “A family member can also use the magnet,” Wheless points out.

Wheless, a neurologist of 18 years who has used the VNS devices since they became available in the U.S. in 1997, nevertheless always begins with pharmaceutical therapy. “Usually we consider that if patient hasn’t responded adequately to two to three drugs, VNS therapy may be appropriate,” he says.

That’s sensible, because VNS epilepsy therapy costs
$20,000 to $25,000, device and surgery included. Medicare and most insurance companies do cover it, though. And Wheless says while data from the US are varied because we don’t have a uniform health care system, “In Europe, the device has been cost-effective” because it reduces expense from hospitalizations and injuries in general.

Worldwide almost 40,000 VNS devices are in use.
One major study showed that after three years, almost three-fourths of VNS implant recipients continued to receive the therapy. Further, for those whom it does help, the benefits tend to improve over time. “We often see gradual improvement not just in the first weeks or months but sometimes out to even 18 months,” says Wheless.

VNS devices can also be used in conjunction with epilepsy drugs,
reducing the needed amount and thereby reducing the possibility of side effects.

For epileptics with the mildest of convulsion, VNS devices aren’t recommended but neither are they only for those who suffer seizures grand mal. Actually, “Most of the devices are for
complex partial seizures such as stopping activity, unresponsiveness, and confusion,” says Wheless. “These are no less devastating than grand mal seizures.”

VNS therapy isn’t without side effects, but they
tend to be mild including local irritation, hoarseness, and coughing, and these generally disappear with time.”

Says Wheless, “If you adjust the device properly you can get close to virtually no side effects.” Further, “You can make settings in office. I can determine results with patients standing in front of me. You can’t do that with medicine.”

The
FDA recently approved VNS therapy for severe clinical depression, and progress with other bionic implants shows we’re truly in an exciting new age therapies for mental disorders for which the “treatment” not so long ago was being chained to a sanitarium wall.

Tuesday, March 21, 2006

Missing woman suffering from seizures disorder found!

A 60-year-old woman who suffers from grand mal seizures and who had been missing since Tuesday was located by San Mateo police Sunday afternoon in San Francisco.

Police found Elysse McCormick around 3 p.m. Sunday at the Transbay bus terminal at Fremont and Mission streets.


McCormick was sleeping and seemed to be in good health, according to police.

Police brought McCormick to San Mateo where she was to be reunited with her family and turned over to Adult Protective Services.

McCormick was reported missing after being discharged from the San Mateo Medical Center around 2:30 a.m. Tuesday.

McCormick had been seen at 5:15 p.m. Wednesday on Serena Drive in Pacifica. She was reportedly looking for her brother who used to live in the area. Later that day, at 8:40 p.m., McCormick was spotted on Fell Street in San Francisco, according to the San Mateo Police Department.

The seizures McCormick experiences can cause loss of consciousness and are often followed by drowsiness or confusion.

Family of famous jailbird ask for release due to Epilepsy

The family of jailed Great Train Robber Ronnie Biggs fear he is near death in prison, and have applied to care for him at home.

Biggs, 76, is in London's high security Belmarsh prison, and unable to talk or eat after suffering four strokes. He has also had two epileptic seizures and two heart attacks, The Mirror reported.
His 31-year-old son Mike told the newspaper Biggs is unable to walk and spends most of his time wired to a heart monitor and intravenous feeding drip.

"I visited him on Saturday but he quickly had to be taken back to his room because he was paralyzed with coughing fits," Biggs' son said. "His doctors think it's a matter of time before he has another fit and that could well be his last."

Biggs escaped in 1965 after serving 15 months of his 30-year sentence for the 1963 train robbery, and returned to Britain in 2001 and is not due for parole for another five years.

Last year, Home Secretary Charles Clarke ruled only a life-threatening illness could secure his release.

Woman suffering from Epilepsy and Alzheimer's is still missing!

Police continued their search Friday for a San Mateo woman who disappeared early this week.
Elysse McCormick, 66, disappeared early Monday morning after she was discharged from San Mateo Medical Center. McCormick suffers from Alzheimer's disease and grand mal seizures.


The woman was spotted in Pacifica at 8:40 p.m. Wednesday near a house her father once owned on Serena Drive. Since then, police believe, she has been to at least two homeless shelters in San Francisco.


Police spent Thursday going to shelters in San Francisco's Western Addition neighborhood and interviewed a number of homeless people in the city. Flyers have been handed out at shelters and at the medical center.

"We've networked as much as we could, so we're hopeful with all the coverage," said Lt. Mike Brunicardi. "I know it's getting a lot of publicity. That's great for us."

Police are also working with McCormick's family to determine where she might be headed next.
"Whatever we can do in order to facilitate her return," Brunicardi said.

Saturday, March 18, 2006

Woman suffering from seizures is missing!

San Mateo police have released a photo of a 60-year-old woman who has been missing since early Tuesday.

Elysse McCormick, who suffers from seizures, was reported missing by a family friend when she failed to return home after being discharged from the emergency room at San Mateo Medical Center around 2:30 a.m. Tuesday, according to San Mateo police. She has been seen in Pacifica and San Francisco since her disappearance, police said.

McCormick reportedly suffers from seizures that can cause loss of consciousness and can be followed by periods of confusion or drowsiness.

Specific circumstances surrounding her brief stay at and release from the hospital were not disclosed, but Medical Center spokesman Dave Hook said that McCormick was found suitable to be released from the hospital.

``Doctors and nurses evaluated and found that she was able to be released,'' Hook said. ``Right now our primary concern is her safety. We're working closely with the Police Department to help with the search.''

Authorities did not say whether similar incidents involving McCormick had occurred previously.
She is described as a white woman, 5 feet 2 inches tall, with brown hair and hazel eyes. She weighs about 120 pounds and was last seen wearing black sweat pants, according to police.

Anyone with information about McCormick's whereabouts is asked to contact the San Mateo Police Department at (650) 522-7700.

Tuesday, March 14, 2006

New way to prevent future febrile seizures

These convulsions are "scary and very upsetting to parents," said Robert L. Macdonald, M.D., Ph.D., professor and chair of Neurology at Vanderbilt. They've also been something of an enigma, he said. The epilepsy research community has struggled to understand how fever ignites convulsions and how to treat them.

Macdonald and colleagues including Jing-Qiong Kang, M.D., Ph.D., research assistant professor of Neurology, have now discovered a molecular mechanism that could explain febrile seizures. The research, published in The Journal of Neuroscience, may lead to new approaches for preventing recurrent febrile seizures in vulnerable children.

Febrile seizures affect as many as one in 15 children worldwide, generally between the ages of 6 months and 6 years. Most children will suffer no long-term consequences from the convulsions, which tend to be generalized - involving the whole body - but some will go on to develop epilepsy.
"It has been very controversial through the years: do you treat febrile seizures or not?" Macdonald said. Several studies have investigated treating children with anti-seizure medications such as phenobarbital or sodium valproate to prevent recurrent febrile seizures, but the studies showed only limited benefit to the approach, Macdonald said.

"That idea has gone by the wayside, and it has not been replaced with any rational strategy for preventing or avoiding subsequent febrile seizures," he said. "The promise of knowing what causes the febrile seizures is part of the excitement about this work." Kang got interested in febrile seizures when she was working as a neurologist and epilepsy specialist in her native China.
"I was always impressed by how quickly fevers can trigger convulsions in children," she said. "I have been curious about this mystery for years."

Kang came to Vanderbilt to work with Macdonald, internationally renowned for his research on epilepsy and GABA-A receptors, proteins on the surfaces of nerve cells that normally quiet the brain's excited chatter.

GABA-A receptors were long suspected to play a role in epilepsy because they are the major inhibitory receptors in the brain and might therefore dampen the hyperexcitability that characterizes seizures. Phenobarbital and other barbiturate drugs and anti-anxiety drugs like Valium exert their calming effects by enhancing the activity of GABA-A receptors.

Indeed, mutations in GABA-A receptors were linked to inherited forms of epilepsy beginning in 2001. Macdonald's group has been characterizing the functional defects of the mutant GABA-A receptors, offering insight into the mechanisms underlying those epilepsies.

One of the common features in the families with mutations in the GABA-A receptor gamma subunit - one of several protein "parts" that come together to make a functional receptor - is a history of febrile seizures.

Kang and Macdonald had already discovered that GABA-A receptors containing mutant gamma subunits were not as good at getting to the neuronal cell surface, and Kang wondered what would happen to these receptors when they were exposed to high temperatures. She raised the temperature of cells expressing the mutant receptors to 40 degrees Celsius, simulating a "fever" of 104 degrees Fahrenheit, and she found that the receptors disappeared from the cell surface.

Fewer inhibitory GABA-A receptors on the cell membrane could leave a neuron open to the excitation and repetitive firing that characterizes seizures. The investigators are currently studying where the receptors go when the temperature is raised - are they taken inside the cell more quickly, are they degraded, is their forward insertion into the cell membrane slowed?

"Trying to get at why the surface receptor levels are reduced requires a whole set of complicated approaches," Macdonald said. "It's like looking out the window and counting the cars on the street: it's easy to count how many are there at any time, but if we want to know where they all came from and where they're all going, that's a whole different problem."

The team's discovery that high temperature reduces cell surface GABA-A receptor levels "raises the idea that one could develop a treatment for vulnerable patients that would prevent them from developing febrile seizures and possibly epilepsy," Macdonald said. Vulnerable patients include children who suffer recurrent febrile seizures, febrile seizures that involve only part of the body (partial instead of generalized), and long-lasting febrile seizures, as well as children with genetic mutations linked to inherited epilepsies. These patients have a higher incidence of developing epilepsy.

"There's a huge incidence of febrile seizures, so even though only a small percentage - 2 to 4 percent - progress to epilepsy, it represents a large burden of epilepsy in the world," Macdonald said. "Our findings are attracting attention because they show a novel mechanism for febrile seizures, and now that we know a vulnerable step, we can in principle design therapeutic strategies to overcome it."

Saturday, March 11, 2006

Could modified Atkins diet help with seizures?

A modified version of a popular low-carbohydrate, high-fat diet is nearly as effective at controlling seizures as the highly restrictive ketogenic diet, Johns Hopkins Children's Center researchers report.

"Our findings suggest relatively good efficacy compared to the ketogenic diet," said Eric Kossoff, M.D., a pediatric neurologist at Johns Hopkins Children's Center. "With 20 patients, our study wasn't large enough to say patients and physicians should replace the proven, but highly restricted ketogenic diet, but the results are encouraging and intriguing."

The common elements in both the ketogenic and Atkins diets are relatively high fat and low carbohydrate foods that alter the body's chemistry. The ketogenic diet mimics some of the effects of starvation, in which the body first uses up glucose and glycogen before burning stored body fat. In the absence of glucose, the body produces ketones, a chemical by-product of fat that can inhibit seizures. Children who remain seizure-free for two years on the ketogenic diet often can resume normal eating without the return of seizures.

The modified Atkins diet is better tolerated by children and may be easier for parents and children to follow, said Kossoff, who presented the study's findings today in Washington, D.C. at a meeting of the American Epilepsy Society.

While the ketogenic diet has proven effective in controlling pediatric epilepsy since its introduction in 1921, it has several drawbacks and side effects. The highly restrictive regimen requires accurate measurement of all foods and liquids to ensure consumption of the proper ratio of fats, carbohydrates and protein necessary to produce ketones. The diet starts with a brief fast and hospital stay during which time families are trained in the rigors of the diet. Side effects can include kidney stones, constipation and slowed growth.

The modified Atkins diet also produces ketones, but requires no restrictions on calories, fluids and protein, and does not require a hospital admission and fast to begin. It also does not require the accurate weighing and measuring of foods, which may translate to better compliance with the regimen, researchers concluded.

"The key here is ketosis - the production of ketones - which both diets create," Kossoff said. "This study suggests that for some children, we need not be so restrictive in allowing protein, weighing foods and counting calories. That should make it a little easier for parents and children to do."
The Hopkins study examined 20 children (ages 3 to 18) who were having between 4 and 470 seizures a week and whose illness was unresponsive to drug therapy.

The children were put on a regimen that included fewer carbohydrates than the standard Atkins diet, for six months. Of the 16 who completed the study, 13 had a greater than 50 percent improvement in seizures, seven had a greater than 90 percent improvement and four were seizure-free. A third of patients did not benefit from the diet. Side effects overall were low, with one child developing a complication that did not warrant stopping the diet, despite a brief hospitalization. The majority of children gained weight in the study.

Kossoff cautions that parents should not try any diet regimen for epilepsy without supervision and careful medical management by a specialized health care team. He and his colleagues also warn that the newly tested regimen should be seen only as a first step in acquainting families with the rigors of the ketogenic diet. It may also be an option for adolescents and adults, not typically offered the ketogenic diet.

Chechnya women suffer from mysterious illness that includes seizures

Young girls in war-ravaged Chechnya are complaining of a mystery illness, stoking suspicions that Russia has used the republic as a testing and dumping ground for nerve gas and other poisons.
Yesterday, it was reported that four women and two teenage girls have been taken to hospital with the symptoms, bringing the number of people to fall ill with the condition since mid-December to almost 100.


The symptoms are extreme: blackouts, fits, breathing problems, nosebleeds, crazed laughter and hallucinations.

Some of the girls who have been afflicted have had prolonged violent fits and spasms up to 25 times a day and have become so disorientated that they could not recognise their own parents.
The authorities and some, but not all, of the medical professionals who have studied the problem have concluded that the mainly female victims are suffering from "mass hysteria". A psychological breakdown, prompted by more than a decade of separatist war which they argue has led to chronic stress, is only now beginning to manifest itself, aggravated by Chechnya's poverty, extreme hopelessness and militarisation.

But the children's parents and some of the doctors who originally treated the girls beg to differ. They believe a cover-up is under way and are convinced that the symptoms have been caused by chemical weapons allegedly used or stored by both sides in the brutal conflict.

The problem came to the authorities' attention on 16 December when schoolgirls in several villages lost consciousness, the prelude to what turned out to be an unending succession of fits and trauma. A handful of boys fell sick too but the vast majority of sufferers were girls or female teachers from at least five different schools.

The authorities' first reaction was to say that they thought the victims had been poisoned and a criminal investigation was opened. The schools were closed pending an inquiry and it was suggested that the lavatories were likely to be the prime source of the poisoning and that the schools' water supply had somehow become contaminated.

That investigation was swiftly dropped, however, along with the poison theory, when a series of specialists, some of whom had flown in from Moscow, said the disorder was psychological. The doctors blamed the media for triggering more cases of the condition with alarmist reports.
Treatment for what is apparently a psychological disorder such as intensive music therapy has proved largely ineffective though. In fact, the only medical success in treating the condition is shrouded in mystery.

A group of the worst sufferers were taken to a hospital outside Chechnya where doctors injected them with substances that alleviated many of the worst symptoms but which caused the girls to put on huge amounts of weight. The doctors have not said what was in the syringes.

Blood samples from five of the sufferers have also revealed the inexplicable presence of ethylene glycol, a toxic substance used in anti-freeze.

Moscow has remained silent. Anna Politkovskaya, a Russian independent journalist specialising in Chechnya, is convinced that Moscow has used the republic as a weapons laboratory.

"It is now 2006. Behind us are 11 years of war with short breaks for clearing mines and unexploded shells," she wrote in the bi-weekly Novaya Gazeta. "But the ideology remains: as before, people who have the misfortune to live in Chechnya are seen as biomaterial for experiments."

Friday, March 10, 2006

Two children affected with deadly seizures disorder

A 2-year-old boy in Lakeville, Minn. died last year of Alpers' disease, and his 11-month-old sister has been diagnosed with the same rare genetic disorder.Shannon and Rand Olson had two healthy boys and a girl on the way when one son, Drew, began having massive seizures.

Drew, who was 13 months old at the time, eventually lost his sight, and no one knew what was wrong."He would push so hard to get better," Shannon Olson recalled. "He went to therapy after therapy after therapy, trying to get stronger and get his skills back. He never gave up. He was just a little fighter."Nine days before he died, a blood test showed Drew had Alpers' disease, a rare genetic disorder.Drew died on Aug. 22, 2005.

Three weeks later, the entire Olson family was tested. Daughter McKenna tested positive for Alpers' disease; both her parents are silent carriers of the Alpers' gene."We wouldn't have had children (if we knew)," Shannon Olson said. "It's too risky. One out of four? There's no way that I would risk it."McKenna remained healthy until three weeks ago.

She developed the same symptoms as her brother: seizures; the inability to sleep for any length of time; the loss of muscle use."(I'll) spend each day with her I can," Rand Olson said, "not looking ahead to what's going to happen, and try to make the best for her."The Olsons now face the death of a second child."There needs to be more research on these diseases," Shannon Olson said. "Because kids are dying, and not only that, they're suffering."

Wednesday, March 08, 2006

Sometimes, a birthmark can be more than a stain

Sometimes a birthmark is more than skin deep. It can be a sign of a profound developmental problem that requires prompt medical attention in a newborn. And it can mean parents must make agonizing choices on behalf of their child, ranging from powerful drug treatments to brain surgery.Kathleen Moore was confronted with just such a challenge 13 years ago when her daughter, Danielle, was born with a dark red birthmark covering half of her face.

The delivery room nurses tried to reassure Ms. Moore that the birthmark, known as a port wine stain, would fade with time. But she had her doubts. This blemish just seemed too big to disappear. She feared her child would have to go through life with a disfigured face.Ms. Moore had good reason to worry, although she had no way of knowing the full extent of the difficulties that lay ahead. Her pediatrician also suspected something else might be deeply wrong.

After a series of tests, Danielle was diagnosed with Sturge-Weber Syndrome, a rare condition in which the birthmark extends to the brain itself.Small port wine stains are relatively common. (Former Soviet leader Mikhail Gorbachev has one on top of his head.) They are caused by an overabundance of blood vessels just underneath the skin. However, a tiny fraction of children with extensive facial birthmarks also have similar malformations on the brain.

The condition occurs in one of every 50,000 births.Essentially, an unusually thick mat of blood vessels covers a portion of the brain surface, explained Dr. Mary Connolly, a neurologist at British Columbia's Children's Hospital in Vancouver.As a result of this abnormal growth, blood can be diverted away from underlying brain tissue and a child suffers from what amounts to series of strokes. This brain damage, in turn, leads to seizures that can cause even more harm.

In Danielle's case, the seizures "came on with a vengeance" at just five months of age, recalls Ms. Moore, who lives in Port Coquitlam, B.C. Some episodes lasted for more than an hour and anti-seizure medications did little to reduce their frequency or severity. There was a very real risk these seizures would lead to extensive damage to the child's already challenged brain.Ms. Moore was faced with a horrific choice: She could let the seizures take their own course or opt for a hemispherectomy -- the surgical removal of part of the brain.

By cutting out the damaged part of the brain, it was hoped the seizures would be stopped or at least lessened. From the experts in the field, Ms. Moore learned her daughter's prospects for recovery would be much better if the surgery were done as soon as possible. An infant's brain is still developing and relatively "plastic." That means the remaining parts of the young brain can learn to partly compensate for what has been lost.So, at the age of 8½ months, Danielle underwent surgery to remove much of her left cerebral hemisphere, almost half the brain. The top layers of grey matter (the "thinking" elements) were cut away on the left side of her brain.

The underlying white matter (the "wiring" which connects different parts of the brain) was left intact."Although this is a dramatic thing, it is the best thing for saving function and controlling seizures," said Dr. Douglas Cochrane, the neurosurgeon who performed the operation at the Children's Hospital.Fortunately for Danielle, the operation paid off and her seizures were significantly reduced. Still, it hasn't been easy growing up with what amounts to half a brain.

Her physical movement is limited on the right side of her body and she suffers from learning disabilities."Danielle did not learn to walk by herself until she was at least three years of age. Speech was also very slow to come," Ms. Moore said.School presented more challenges. Ms. Moore, a single parent, has struggled to make sure her daughter got the attention she needed. "I had a teacher approach me and say, 'Your daughter may never learn to read.'

But I wasn't going to take that for an answer."Despite the severity of the surgery, Ms. Moore said she has no regrets. "I am glad I made the decision I did because, in her case, the seizures came on at a very young age. That is usually the hallmark for serious problems down the road . . . And if you can't get these seizures under control, they can cause further brain damage."

Other parents have chosen different paths for their children and are just as convinced they did the right thing.Mariea Strangway and her husband, Walter, rejected the idea of a hemispherectomy for their daughter Lisa almost four decades ago. At that time, the Sarnia, Ont., couple went to Toronto to consult with medical experts at the Hospital for Sick Children.One doctor at Sick Kids urged them to consider the operation."It sounded pretty severe . . . and we never did it," recalls Mrs. Strangway.

Years later, "we would pat ourselves on the back and say 'Thanks heavens, we didn't do that.' "Even so, "Lisa suffered from an awful lot of seizures" and the medications produced wild swings in behaviour. "It was just hellish. We would go through periods of five days and nights without sleep" because the child was so hyped-up by the drugs.What's more, Lisa also suffered from severe learning disabilities. And the Strangways had "to fight tooth and nail" with the local school board to get special help for their daughter.

Lisa is now 38 and lives with her widowed mother. She has a job at a sheltered workshop with other people with special needs.In many respects, both Danielle and Lisa ended up with a lot of similar developmental problems, even though their parents chose very different treatment options."Any time you are going to really batter a little brain around, I think you will get some developmental impairment that follows," Dr. Suzanne Jacobsen, a Vancouver psychologist who treats children with complex developmental disabilities, including Danielle.

In recent years, there have been several medical advances that are making a difference in the bleak outlook for patients with Sturge-Weber Syndrome."There are better drugs today for controlling seizures," said Dr. Daune MacGregor, a neurologist at Sick Kids in Toronto. Improvements in medical imaging -- such as CT scans and MRIs -- provide clearer pictures of the damaged regions of the brain, so surgeons have a better idea of the children who would be suitable candidates for surgery even before the skull is opened.

That has meant fewer hemispherectomies are now done. When the operation is performed, surgeons tend to remove less of the actual brain tissue, compared with a decade ago. Instead, the connections between different parts of the brain are severed to limit the effects of the seizures."Ideally, you would never have to do a hemispherectomy . . . but we are not there yet," said Dr. Jacobsen.

"The important thing is that parents have all the information to make the decision that feels right to them because there are so many variables -- the child's age, the number of seizures, even how much of the brain is consumed by the port wine stain."Inside the mind of a childA child's brain is an amazing thing. If a region becomes damaged, there is a strong likelihood other parts will pick up the slack. That's because the mind is still developing and certain tasks have not yet become rigidly assigned to particular areas within the brain.

Suzanne Jacobsen, a Vancouver psychologist who specializes in kids with complex developmental disabilities, says this "plasticity" exists up to the age of 6, and possibly later. But, she adds, "I have seen far better recovery from a brain injury under the age of 2, compared with a similar injury that occurs over the age of 2."Still, there are limits to just how much a young brain can adapt. Children who have undergone hemispherectomies -- surgical removal of half or part of the brain -- often suffer from limited movement on one side of the body.

There may be visual impairments as well. "You don't lose your vision, you just might have to turn your head to see in a particular direction," said Dr. Mary Connolly, a neurologist at British Columbia Children's Hospital. Many children will also suffer from varying degrees of learning disabilities and cognitive deficits."It is no mystery they would have learning-related issues. . . .
They are functioning with half of what the rest of us function on," said Dr. Connolly. "But many of these children function very, very well."

From a fever to seizures

It took a wrong turn on a Sunday, Father's Day of all days, the day Eric Dolch got really sick.
He'd been complaining of a headache all week, and that Friday he'd gone to the doctor.
Antibiotics, the doctor said.


The kid had a little something.

But by Sunday the fever was up again and by Monday he was delirious and his mom, Ava Van de Water, a former co-worker of mine, called the doctor.

Emergency room, the doctor stated succinctly.

And that's how a 14-year-old boy ends up in a coma for four months.
It's just that easy.

Unanswered questions

There's a lot the medical teams don't know about Eric Dolch. If he'll get better. If the seizures will stop. If, if, if.

But this they know:
The smiling kid with swell manners and a tender heart had encephalitis last summer. Some virus inched its way into this child's brain, although the experts aren't sure how it started. Eric tested negative for the mosquito-bite kind.

"We'll probably never know," says his mom.

Her son's supposed to be a high school freshman, and instead he's slept since June.

Van de Water, a local girl who grew up in Palm Beach and went to school here, is married to Craig Dolch, who happens to be the newspaper's golf writer. They circulate in not-so-shabby circles, from friends on the island to friends from the golf world. Barbara Nicklaus has kept in touch through all this.

Encephalitis isn't common, maybe 2,000 cases reported to the CDC each year. But after the coma, which they medically induced to control the seizures, they moved Eric from Miami Children's Hospital to a Boston rehab center.

He's still heavily sedated, mostly immobile, although the number of seizures is down dramatically.

Readjusting expectations of ordinary

Things like this tend to change life and its many definitions: Marriage. Debt. Happiness. A good day. When Craig Dolch wrote about Eric a few months back, he used a great line.

"And I thought talking to Curtis Strange after a double-bogey on the 18th hole was tough," he said.
Now, a Curtis Strange anger management situation would be a walk in the park.

They've got Eric on a special diet, and it's fed to him through a tube into his intestine. The diet's supposed to help stop the seizures. Craig Dolch is in Boston. Van de Water and their daughter, Alexandra, 16, fly to Boston as often as they can. Alexandra will graduate from high school this spring, a year early, and she's second in her class.

Apparently, the apple doesn't fall far from the tree.

"Life is tough," Van de Water says now. "But it's life."

When our boys were little, Van de Water and I sat cubicle-to-cubicle in the feature sections of this paper. Our sons, her Eric and my Ian, are the same age. And while the children never played, we did — she and I — in those early-morning work hours.

We'd entertain each other with lovely anecdotes of our sweet boys. Work and home and guilt was almost always the subtext.

After talking to my former colleague one recent day, I took a breath, wiped my eyes, called my son, who was home sick with a bug.

He answered on the millionth ring, which annoyed me, and mumbled into the telephone, which annoyed me. And when our lovely conversation was over, he hung up without even saying goodbye — which annoyed me.

What this family wouldn't give for some of that.

Thursday, March 02, 2006

Aspartame may cause seizures

My name is Sean Houlihan. I’m writing you to hopefully inform your audience of Aspartame. I’m a former Board Member of Epilepsy Foundation If you are not aware, aspartame is by far the most toxic sweeter and caused me seizures for 15 years (and subsequent brain surgery). This same scenario is currently underway thousands of times over across the country. Class action suites are already underway for seizures and aspartame.

The military has recently warned its pilots not to use aspartame because of seizures. http://www.aspartamesafety.com/toc.htm (5 sections down on the page) Coke also knew that aspartame caused seizues in controlled studies with monkeys, and initially opposed it being approved because smart biochemist warned of this years ago.

http://www.newstarget.com/008952.html http://www.mercola.com/article/aspartame/fda_... Through bribes and payoffs, aspartame was approved. Here is how my own personal story went down.As a 17 year old, weight-conscious teen I began drinking diet coke like water (and continued until about 2 years ago)- at least a two liter bottle a day. My "dizzy spells" ensued about 2 months later. In '85, when they started I actually brought it up to my doc - “could it be the diet coke?”

He dismissed it (in hindsight, he would not have known of anything because it had just been approved). I continued to drink diet coke (at minimum a liter a day for 15 years - which a lot of people do). My seizures continued, and I had debilitating anxiety. (all classic aspartame poisoning symptoms- aspartame destroys the central nervous system by preventing the synthesis of seritonin. http://www.laleva.cc/food/aspartame_awareness... ) I have read studies done on humans and the reactions were so severe they had to be stopped (in NYC , in '96 my mom and dad thought they were going to have to take care of me for the rest of my life because I was such a neurotic mess, anxiety, seizures etc….)

My neurosurgeon now agrees with me as of three months ago – he said in '97 when I had my surgery that they still were not quite aware of this. This may sound crazy, until you research it on the web, and find hundreds, even thousands of stories exactly like mine. Hundreds of independent studies that conclusively prove it causes seizures and anxiety. Mid 80’s, (when aspartame got approved) started drinking a lot of diet coke, seizures started, etc….

I have read countless stories of this / my exact case, people put on the same anti seizure medication, and 10-15 years of their life ruined (though none quite as bad as mine) Coke has paid off studies, and regularly threatens lawsuits from preventing this from being mainstream knowledge but it’s coming down. I know how much diet coke I drank, at least 1-2 2 liter bottles a day, and unquestionably this is what happened.

They are saying this scandal is going to be larger than the tobacco scandal. 60 minutes, and all major networks have been working on documentaries, and they have consistently back down because of litigation.Just enter aspartame, aspartame side effects, aspartame seizures, aspartame sudden cardiac arrest, diet coke side effects, etc. in google or yahoo and you can research it for yourself and see what studies have concluded.Some interesting links: http://www.mercola.com/article/aspartame/hidd...

How aspartame became legal http://www.rense.com/general33/legal.htm
http://www.321recipes.com/aspartame.htmlhttp://www.nexusmagazine.com/articles/asparta...
http://www.wnho.net/aspartamenews.htm World health organizationFor those who find this difficult to understand, there is a scientific reason for this. A genetic disorder called PKU phenylketonuria(which we are all screened for at birth) make the consumption of phenylalanine, an ingredient in aspartame deadly. People with PKU cannot use aspartame.

Carriers of the PKU gene are not effected with PKU, but can pass the gene on. Studies show that PKU carriers are much more succeptable to the adverse effects of aspartame. Ironically, these carriers are mostly decendents from Northern Europe, and PKU individuals usually have blue eyes. My grandparents are from Newfoundland, and Ireland, and I also have blue, blue eyes. (my best trait) This is interesting because the amount of PKU carriers in the US is in the millions, and my assumption (and those of biochemist) is that these are the individuals who suffer what I did when using aspartame.

Just an FYI, I’m not a quack. I‘m a successful business person who owns www.QuoteMeAPrice.com, www.PersonalsSites.com, www.HotAmericanSingles.com as well as www.HotLASingles.com, HotDallas, etc.

Medicine for seizures, criticized

A U.S. Customs policy to step up seizures of prescription drugs from Canada is raising protests in Congress and allegations from Sen. Bill Nelson, D-Fla., that it might be a ploy by the Bush administration to force Americans into the new Medicare prescription-drug plan.Federal agents have begun releasing the seized drugs to elderly customers such as Melbourne resident Dorothy Donnelly, 74.

But the disabled widow, who orders about half of her nine prescriptions from Canada because they are cheaper, said she's worried the drug seizures will happen again."I can't afford to pay all that medicine," she said. "I think they want us to get this Medicare D, which no one can understand."Medicare Part D is a voluntary insurance program under which most seniors pay part of the cost for their prescription drugs.

Enrollment for the program began in November, just as Customs officials began seizing more of the drugs seniors are importing from Canada.Customs spokeswoman Lynn Hollinger said there's no connection between the two. The drugs are being seized because they are illegal and could be dangerous to seniors, she said. U.S. law forbids patients from ordering drugs from outside the country because there's no guarantee that foreign pharmaceuticals have gone through the same safety reviews as the U.S. Food and Drug Administration requires.

According to the Kaiser Family Foundation, about 5 percent of seniors order drugs from Canada or Mexico. In Florida the figure is 10 percent, according to the nonpartisan group. Seniors and many members of Congress are pushing to allow importation from Canada because prices are lower.Nelson has called for an investigation by officials at the Department of Homeland Security, which includes Customs, into whether the crackdown was linked to the administration's drive to sign up seniors for the new Medicare plan.

Nelson's staff said he had received 140 calls from seniors complaining in the past week or so.Rep. Ginny Brown-Waite, R-Crystal River, also has received complaints. Like Nelson, she favors allowing Canadian imports. Brown-Waite has complained to the administration that it should notify seniors that the practice of ordering from Canada is illegal before seizing the medicines they need.Sen. Mel Martinez, R-Fla., said he didn't see any political motivation for stepping up the seizures but would like to see the Canadian imports legalized.

"I support people's rights to get their drugs as cheap as they can get them including from re-importation, if safety can be assured," Martinez said.

Surgery of the brain performed on the internet

Temporal lobectomy, a surgical procedure that involves removing parts of the temporal lobe that cause seizures, is offering hope to epilepsy patients who have not been responsive to medical therapy.

Neurologists and neurosurgeons at Wake Forest University Baptist Medical Center use electroencephalograms (EEG), positron emission tomography (PET) and magnetic resonance imaging (MRI) in the state-of-the-art Epilepsy Monitoring Unit (EMU) to pinpoint the exact origin of the disease. Surgeons then remove the scarred tissue to reduce or eliminate the seizures.

On Wednesday March 1 at 5 p.m. neurosurgeon Steven Glazier, M.D. will perform a temporal lobectomy during a live Internet broadcast. The surgery removes a small part of the temporal lobe, part of the brain that extends from the temples to just past the ears.

"Patients must have failed at least one standard and one new medication to be considered for surgery," he said.

"We are working in high-risk territory so we use imaging tests to carefully pinpoint the origin of the seizures so that we make sure we leave the pathways for speech, movement and memory intact," said Glazier, M.D. "Eighty percent of patients are cured with this procedure and ninety-five percent have a dramatic reduction of their seizures. It adds a tremendous amount to their quality of life." About 15 to 30 temporal lobectomies are performed each year at the medical center.

The Comprehensive Epilepsy Center at Wake Forest Baptist provides Level IV care -- the highest level of care available. Full-time epileptologists, a neurosurgeon experienced in epilepsy surgery, nurse clinicians, social workers, pharmacists and neuropsychologists work with patients and their families to help diagnose and treat the disease, which affects about one percent of the population.

With its comprehensive approach to care, Wake Forest Baptist houses the only program in North Carolina to meet the guidelines of the National Association of Epilepsy Centers for top-level medical and surgical centers.

Researchers at the medical center are working to find a cure for the disorder and their patients benefit from a variety of treatment options.

"Just 10 years ago seizure-free living was unthinkable for many people with epilepsy," Glazier said. "Today that can be achieved even in difficult-to-control cases."

Medical condition that causes seizures

Tamara Moore has not been bashful about sharing her son's story.

When she and son Dallas Hill flew to Phoenix in the summer of 2004 for revolutionary surgery, Southwest Airlines filmed the trip for an episode of the A&E network's television show "Airline."
The surgery, performed at Barrow Neurological Institute, successfully removed a lesion from Dallas' hypothalamus, the area at the base of the brain that regulates things such as body temperature, emotion, sex drive, sleep and appetite.

The condition, known as hypothalamic hamartoma, is extremely rare and causes seizures that usually get worse as a child grows up.

Dallas' odyssey was one of three storylines on an episode of "Airline" that aired in October of 2004. The show followed Dallas from Portland International Airport, into the operating room, and back home to his new life.

"I think having the TV cameras on, it took all the stress off of me," Moore said. "I worried about (being on TV) instead of the important stuff."

Dallas' story ended up on "Airline" because the father of another hypothalamic hamartoma patient is a pilot for Southwest Airlines.

At the time of Dallas' operation, several Portland-Vancouver television stations reported on his condition. The Columbian wrote about Dallas 14 months ago, when he was beginning to learn to skate.

Moore said she's shared their ordeal with the hope that it helps other people facing mysterious medical challenges.

"I just would like other people to know: Don't give up," she said.

"If you're in that situation, you feel so hopeless and lost," she said. "But great things happen."

What to do if a child has seizures?

Seizures are caused by abnormal electrical discharges in the brain, the Nemours Foundation says.

Although they are frightening, seizures are rarely life-threatening.
The foundation offers these suggestions if a child has a seizure:
If possible, gently place the child on the floor.

Loosen the clothing around the neck.

Do not try to prevent the child from shaking.

Roll the child onto his side, so if he vomits, he won't choke.
Contact a physician.

New treatment for seizures

Alison Barth, assistant professor of biological sciences at Carnegie Mellon University, received a $50,000 grant from the Milken Family Foundation to further her research on a novel treatment for seizures. A drug that acts on a single ion channel is the key to this new treatment, which she hopes will one day be used to prevent seizures in children.

Barth’s research identified a specific neuronal target that, when blocked with the drug, significantly reduced seizure occurrence and frequency in vitro. The real surprise came when she made the switch from in vitro to in vivo, testing the drug within a living organism and finding that it worked very well.

The target in question is an ion channel, a structure through which ions, or charged atoms, can cross cellular membranes. Ion flow in and out of nerve cells controls the chemical and electrical levels necessary for action potentials to occur. An action potential is an electrical signal — a messenger — that travels from neuron to neuron, relaying information as it goes.

Ion channels are directly responsible for electrical activity in a nerve cell, and malfunctions are a likely cause of seizures. Seizures occur when abnormal electrical activity in the brain results in involuntary changes in function or behavior. Barth looked at graphs of action potentials from neurons of healthy mice and mice that had had seizures. Action potentials have well documented and consistent shapes. A normal action potential would therefore look different than one recorded during a seizure.

“It’s a lot like Sesame Street,” Barth said. “They show you four [pictures] and say: ‘Which one doesn’t belong?’” In this way, Barth was able to identify which ion channel was responsible for the recorded changes in action potentials during a seizure.

Barth noted that the chances of having a seizure in a lifetime are very low, around one percent. However, one seizure increases the likelihood of a second 50-fold. The chances of having a third seizure increase by 80 to 90 percent, and the numbers continue to rise.

Spontaneous recurrent seizures, commonly known as epilepsy, affect between 1.4 and 2.7 million people in the U.S., according to the Centers for Disease Control and Prevention.

Barth hopes to interrupt the development of epilepsy from recurrent seizures. “I’m a newcomer to the epilepsy field,” Barth said. “The grant allows researchers with novel ideas and new approaches a chance to explore.”

To test its efficacy, Barth injected the drug into mice, though still unsure of the rate at which it would be metabolized or the likelihood that it would cross the blood-brain barrier to reach neurons. After several trials, Barth found that administering the drug concurrently with seizure induction effectively eliminated all seizures. “We stumbled upon this finding,” Barth said. “I just asked a student try the experiment.”

Barth pointed out that the core discovery was that “this particular target treatment could prevent seizures in vivo.” That is, the drug could be administered to a living animal and produce results.
“It is likely to be an orally administered drug, based upon the compound’s structure, although we haven’t tried it,” Barth said. “And it might be effective for people at risk of developing epilepsy and could be a therapy to prevent epileptogenesis.”

This is good news, particularly for young children, who make up a third of all newly diagnosed cases of epilepsy each year and are in danger of developing more severe forms of epilepsy as they grow older. The drug’s efficacy is another reason why Barth is eager to push her research forward so that it can go on to clinical trials.

“For a new drug to get to the clinic, it has to be commercially attractive,” Barth said. She is currently in the process of protecting the compound with a patent. However, there is still much work to be done before clinical trials start, including finding a company to partner with. “We would like to work with someone who will pursue this further,” Barth said.

The grant has given Barth a big imperative to make progress. “It is a one-year grant,” Barth said. “We received the money very quickly and therefore we can really do a lot of experiments to investigate this.”

Barth hopes her research advances will help her obtain a larger grant from the National Institutes of Health. She is also looking for other sources of funding. “It’s a clinically exciting compound,” Barth said, “and we are trying to get it to the clinic as soon as possible.”

The progression of this project was “a tribute to basic research and persistence,” Barth said. “It has spawned a dozen other projects in the lab.” Future research projects for her lab include examining the possibility of predicting if and when spontaneous recurrent seizures will develop. Those seizures could then be prevented with Barth’s innovative treatment.


Former boxer fights for his life!

Former WBA heavyweight champion Greg Page, who sustained brain damage during a 2001 fight, remained on life support yesterday.

The 47-year-old boxer was in the intensive care unit at a hospital suffering from acute respiratory failure, sepsis, hypothermia and seizures.

"His fever has gone down a bit but he's still on the ventilator," hospital spokeswoman Angie Rose said.